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What is the treatment for a blocked ureter?

Answered by: Dr. Rajesh Ahlawat
Director, Urology and Renal Transplantation
Fortis Hospitals
New Delhi

Q. What are the treatments available for a blocked ureter? My father has a tumour of the ureter, which has caused the blockage. He used to have a stent but the ureter is now so blocked that the doctors can't place a new stent. He has a tube coming out from his back to drain the urine into a bag. He had colon cancer, for which he was treated but the cancer has reappeared on the ureter. He has had both radiotherapy and chemotherapy for this new tumour. The doctors in Malaysia are saying that he may have to have his kidney removed. Please suggest.

A.  Surgical treatment of a block in ureter may be temporary or permanent. Temporary treatment is done with stents and nephrostomy diversion. The definitive treatment is by bypassing the block to bladder or to the other ureter; or removal of offending segment and bringing the two ends together. A temporary treatment is usually the first step, and later converted to a definitive treatment if the disease is benign. The cancerous blocks can also be treated by complete removal of the kidney and its tube if the disease can be removed completely along the removed part. Incurable or advanced disease is usually treated with changing the tubes of temporary diversion at certain intervals. Single available stents are usually insufficient to drain the ureters if the disease is compressing it from all around. Special stents have been designed for such cancerous blocks. Many a time putting double stents through such ureter may do the trick. Your urologist would be aware of all these options and would make the right decision.

A.  Surgical treatment of a block in ureter may be temporary or permanent. Temporary treatment is done with stents and nephrostomy diversion. The definitive treatment is by bypassing the block to bladder or to the other ureter; or removal of offending segment and bringing the two ends together. A temporary treatment is usually the first step, and later converted to a definitive treatment if the disease is benign. The cancerous blocks can also be treated by complete removal of the kidney and its tube if the disease can be removed completely along the removed part. Incurable or advanced disease is usually treated with changing the tubes of temporary diversion at certain intervals. Single available stents are usually insufficient to drain the ureters if the disease is compressing it from all around. Special stents have been designed for such cancerous blocks. Many a time putting double stents through such ureter may do the trick. Your urologist would be aware of all these options and would make the right decision.

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